Provider Demographics
NPI:1659552867
Name:GERALD R WEIS DC INC
Entity Type:Organization
Organization Name:GERALD R WEIS DC INC
Other - Org Name:WEIS CHIROPRACTIC & PHYSICAL THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:FINUCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:513-563-0414
Mailing Address - Street 1:10671 MCSWAIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-3168
Mailing Address - Country:US
Mailing Address - Phone:513-563-0414
Mailing Address - Fax:513-563-9540
Practice Address - Street 1:10671 MCSWAIN DRIVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-3168
Practice Address - Country:US
Practice Address - Phone:513-563-0414
Practice Address - Fax:513-563-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1009111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT47901Medicare UPIN
OH9273271Medicare PIN